I’ve been on TRT for about 6 months now. My hormone levels look a whole lot better, and I feel better too, but not nearly as much as I think I should. I don’t feel like my treatment is quite dialed in yet, or maybe there is something else going on besides low T. I’m hoping that some of the experts here can give me some advice on where to go from here.

My main complaint is energy levels. Before TRT I was dead half the day. I feel much better now, but I’m still pretty tired most of the time, despite having better sleep. Bedroom performance was never a problem, even with low T, but I was so tired that sex was the last thing I wanted. Libido has improved a bit, but not dramatically. I have noticed improved gains in the gym, and better muscle definition in areas that used to lag behind, however fat loss has not happened at all, unless I am eating perfectly clean.

Numbers from my last 3 tests are below, let me know if there are any other metrics you need. Those in red are pre-TRT. Blue is my first protocol, Green is my current.

Old Protocol: 150mg of Test Cyp, once a week. 500iu of HCG, twice a week.
Current Protocol: 75mg of Test Cyp, twice a week, 500iu of HCG, twice a week, 1mg of Anastrozole, twice a week.

I’m thinking of switching to taking test EOD, and possibly lowering the dosage. That should hopefully lower my E2, so I don’t have to take so much AI, while keeping my test in a good range. Any advice? Thanks!

You’re missing a lot of labs, SHBG levels determine how often we inject. If SHBG levels are low you may need to inject EOD otherwise consistent libido and erections will be hit and miss a lot of the time. If you start injecting EOD without lowering your dosage by at least 25% your T and E2 levels will climb significantly and you will need to split up your AI and take it on injections days since T and E2 rise together. E2 where it sits now is fine.

Testosterone has a spectrum of effects on the male organism. This review attempts to determine, from published studies, the time-course of the effects induced by testosterone replacement therapy from their first manifestation until maximum effects...

The lab started using a different method for total and free test, but the levels still look good. Maybe too high.

E2 is getting a little low; I will keep an eye on it.

I got rT3 tested this time. It is a little high compared to fT3, but not far from ideal (I think). TSH spiked high, but I believe that is from the iodine supplement I started taking. I’m only doing 2.5mg a day right now, but I plan to slowly increase that to see if it helps with the hypothyroid symptoms I have. I’m also taking 200mcg of selenium with it.